充气温毯联合液体加温技术预防老年患者围术期低体温的效果  

Effect of Active Forced-Air Warming Combined Warmed Fluids on Prevention of Perioperative Hypothermia in Older Patients

作　　者：赵思文 王琳 刘真 左明章[1] 彭文平[1] Zhao Siwen;Wang Lin;Liu Zhen;Zuo Mingzhang;Peng Wenping(Department of Anesthesiology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730)

机构地区：[1]北京医院麻醉科国家老年医学中心、中国医学科学院老年医学研究院,北京100730

出　　处：《国际老年医学杂志》2023年第2期191-195,共5页International Journal of Geriatrics

基　　金：北京医院博士启动基金(BJ-2015-101)。

摘　　要：目的探讨充气温毯联合液体加温技术预防老年患者围术期低体温的效果。方法采用前瞻性、随机临床对照研究。选择2016年6月~2017年6月在北京医院择期行全麻下腹部手术的老年患者(≥65岁)37例。采用随机数字表法分为两组,单纯采用充气温毯的20例老年患者为温毯组,充气温毯联合液体加温的17例老年患者为联合组。所有患者自诱导前20~30 min开始向温毯持续吹入经加热的气体直至离开手术室。联合组术中静脉输注由温箱38℃保存8 h以上的加温液体,温毯组输入液体均保持室温水平。记录入室后、诱导前、诱导后15 min、30 min、60 min、90 min、120 min、术毕、出室前患者的核心体温。记录术后寒颤发生情况及观察期间出现的不良反应。结果从整体分析发现两组患者的核心温度时间、组间、交互作用比较差异均有统计学意义(P<0.001)。联合组在诱导后60 min、90 min、120 min时的核心体温高于温毯组,差异有统计学意义(P<0.05)。联合组术中低体温发生率低于温毯组(P<0.05)。结论全麻下行腹部手术时,充气温毯联合液体加温技术预防老年患者围术期低体温的效果优于单纯使用充气温毯。Objective To evaluate the effect of active forced-air warming combined with warmed fluids on prevention of perioperative hypothermia in older patients.Methods A prospective and randomized clinical controlled study was performed on 37 older patients(age≥65 years old)undergoing abdominal surgery under general anesthesia.The patients were divided into a forced-air warming group(20 cases receiving forced-air warming alone)and a combination group(17 cases receiving forced-air warming and warmed fluid infusion)according to the random number table.All patients received active forced-air warming at 20 to 30 min before anesthesia induction till leaving the operation room.The patients in the combination group additionally received intravenous infusion of fluids kept in a warming cabinet(38℃)over 8 hours,and the patients in the forced-air warming group additionally received intravenous infusion of fluids kept at room temperature.The core temperature was recorded after entering the operation room,before anesthesia induction,at 15,30,60,90,and 120 min after anesthesia induction,at the end of surgery,and before leaving the operation room.Postoperative shivering and adverse reactions were also recorded.Results The overall analysis showed that there was significant time,inter-group and interaction difference in core temperature in the two groups(P<0.001).The core temperature in the combination group was higher than that in the forced-air warming group at 60,90,and 120 min after induction(P<0.05).The incidence of intraoperative hypothermia in the combination group was significantly lower than that in the forced-air warming group(P<0.05).Conclusion The effect of active forced-air warming combined with warmed fluids on prevention of perioperative hypothermia is superior to forced-air warming alone in older patients during abdominal surgery under general anesthesia.

关 键 词：麻醉 全身 体温 加温技术 老年患者 

分 类 号：R614[医药卫生—麻醉学]